HPA-1a和HLA抗体对初级止血的影响。

Influence of HPA-1a and HLA antibodies on primary hemostasis.

作者信息

Kretschmer V, Huss B, Feller K, Ponath N, Kiefel V

机构信息

Department of Transfusion Medicine and Hemostaseology, Klinikum, Philips University, Marburg, Germany.

出版信息

Semin Thromb Hemost. 1995;21 Suppl 2:96-102. doi: 10.1055/s-0032-1313610.

DOI:10.1055/s-0032-1313610

PMID:7660165

Abstract

The influence of platelet specific and HLA antibodies was investigated on primary hemostasis by the in vitro bleeding test (IVBT) (Thrombostat 4000). Seven of 12 plasmas with HPA-1a (P1A1) antibodies and two with antibodies against glycoprotein Ib/IX significantly inhibited the IVBT of normal, cross-match-positive donor blood. This correlated with a significant increase of GMP-140 (CD 62) on the platelets, determined by flow cytometry. These results agree with the literature showing both activation and inhibition of platelet function by platelet specific antibodies. On the other hand, HLA antibodies showed a similar platelet activation (shortening of occlusion time and decrease in blood volume in the IVBT, increase of CD 62 expression) as plasma samples of polytransfused thrombocytopenic patients without HLA antibodies. It can be concluded that neither an activating nor an inhibitory effect of HLA antibodies on platelet function is significant in vivo. The IVBT seems not to be suited for compatibility testing.

摘要

通过体外出血试验（IVBT）（Thrombostat 4000）研究血小板特异性抗体和HLA抗体对初级止血的影响。12份含有HPA-1a（P1A1）抗体的血浆中有7份以及2份含有抗糖蛋白Ib/IX抗体的血浆显著抑制了正常的、交叉配血阳性供体血液的IVBT。这与通过流式细胞术测定的血小板上GMP-140（CD 62）的显著增加相关。这些结果与文献一致，表明血小板特异性抗体可激活和抑制血小板功能。另一方面，HLA抗体显示出与未产生HLA抗体的多次输血血小板减少症患者的血浆样本类似的血小板激活作用（IVBT中阻塞时间缩短和血容量减少，CD 62表达增加）。可以得出结论，HLA抗体对血小板功能的激活或抑制作用在体内均不显著。IVBT似乎不适用于相容性检测。